PNP Review: Blood Disorders fals
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Questions and Answers

What is the characteristic appearance of bones in Multiple Myeloma?

  • Swollen or inflamed
  • Dense or compact
  • Sparse or porous
  • Punched-out or honeycombed (correct)

    • What is the primary goal of Nursing Management in Agranulocytosis?

  • Administering antibiotics
  • Protective isolation and drug assessment (correct)
  • Promoting ambulation and exercise
  • Monitoring laboratory results

    • What is the primary cause of Coagulopathies in Thrombocytopenia?

  • Clotting factor deficiencies
  • Increased platelet destruction by the spleen (correct)
  • Immune system disorders
  • Decreased platelet production by the bone marrow

    • What is the primary treatment for Disseminated Intravascular Coagulation (DIC)?

    <p>Correction of the underlying cause</p> Signup and view all the answers

    What is the primary symptom of Hemophilia?

    <p>Oozing or bleeding</p> Signup and view all the answers

    What is the primary goal of Medical Management in Aplastic Anemia?

    <p>Withdrawal of the causative agent</p> Signup and view all the answers

    What is the primary goal of administering oxygen in a patient with Hemolytic Anemia?

    <p>To improve oxygen delivery to the tissues</p> Signup and view all the answers

    A patient with Thalassemia is experiencing bronzing of the skin. What type of Thalassemia is likely?

    <p>Cooley's Anemia</p> Signup and view all the answers

    What is the primary cause of Pernicious Anemia?

    <p>Lack of intrinsic factor necessary for absorption of vitamin B12</p> Signup and view all the answers

    A patient with Polycythemia Vera is experiencing reddish-purple face and lips. What is the underlying cause of this condition?

    <p>Rapid proliferation of erythrocytes and leukocytes</p> Signup and view all the answers

    What is the primary goal of phlebotomy in a patient with Polycythemia Vera?

    <p>To decrease the production of erythrocytes</p> Signup and view all the answers

    What is the primary concern for a patient with Leukemia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mechanism of action of radiation therapy in cancer treatment?

    <p>Breaking a strand of DNA molecules, preventing growth</p> Signup and view all the answers

    What is the primary goal of nursing management for cancer patients undergoing chemotherapy?

    <p>Monitoring for side effects and providing dietary modifications</p> Signup and view all the answers

    What is the primary benefit of peripheral stem cell transplant in cancer treatment?

    <p>Replaces bone marrow destroyed by cancer or cancer treatments</p> Signup and view all the answers

    What is the primary purpose of biologic response modifiers in targeted therapies?

    <p>Stimulating the immune system to fight cancer</p> Signup and view all the answers

    What is the primary focus of care for the terminally ill cancer client?

    <p>Maintaining dignity and promoting comfort</p> Signup and view all the answers

    What is the primary mechanism of action of mohs surgery in cancer treatment?

    <p>Shaving off layers of skin to remove cancer cells</p> Signup and view all the answers

    Which symptom is uniquely associated with hypovolemic anemia as compared to general anemia?

    <p>Rapid respiratory rate</p> Signup and view all the answers

    Which intervention is specifically required for a patient with hypovolemic anemia?

    <p>Monitor I&amp;O</p> Signup and view all the answers

    What is the primary cause of sickle cell crisis?

    <p>Inadequate oxygen supply to blood</p> Signup and view all the answers

    For which type of anemia is prophylactic antibiotic therapy indicated?

    <p>Sickle cell anemia</p> Signup and view all the answers

    Which assessment finding is common in both general anemia and sickle cell anemia?

    <p>Dyspnea</p> Signup and view all the answers

    Which of the following is NOT a typical treatment for iron deficiency anemia?

    <p>Bone marrow transplantation</p> Signup and view all the answers

    Which classification of cancer originates from connective tissue?

    <p>Sarcomas</p> Signup and view all the answers

    What is the second leading cause of death in the United States?

    <p>Cancer</p> Signup and view all the answers

    Which factor is NOT a known contributing factor to cancer development?

    <p>Consistent physical exercise</p> Signup and view all the answers

    Which diagnostic test detects tumor markers released by cancer cells?

    <p>Laboratory Tests</p> Signup and view all the answers

    What is indicated by an 'obvious change in size of a wart or mole'?

    <p>Cancer warning sign</p> Signup and view all the answers

    Which treatment method is used primarily to relieve uncomfortable symptoms in cancer patients?

    <p>Palliative surgery</p> Signup and view all the answers

    Which of the following symptoms is most specifically associated with the onset of tumor lysis syndrome?

    <p>Muscle cramps</p> Signup and view all the answers

    Which intervention is critical in managing the potassium levels in patients with tumor lysis syndrome?

    <p>Administering Kayexalate</p> Signup and view all the answers

    What is a primary focus of hospice care for terminal patients?

    <p>Emphasizing quality of life</p> Signup and view all the answers

    What describes the circulatory changes seen in clinical signs of impending death?

    <p>Decreased BP and HR</p> Signup and view all the answers

    What diagnostic tool is used for staging lymphomas?

    <p>Lymphangiography</p> Signup and view all the answers

    Which nursing intervention is vital for a client with Hodgkin Disease experiencing respiratory difficulty?

    <p>Assessing respiratory status</p> Signup and view all the answers

    What is a common assessment finding in both Hodgkin and non-Hodgkin lymphomas?

    <p>Lymph node enlargement</p> Signup and view all the answers

    What is NOT a component of palliative care for terminal patients?

    <p>Administering curative therapies</p> Signup and view all the answers

    What role does promoting adequate hydration play in managing tumor lysis syndrome?

    <p>Maintains urinary output</p> Signup and view all the answers

    What is a common intervention in Hodgkin Disease to protect a patient's bony prominences?

    <p>Support and protect bony prominences</p> Signup and view all the answers

    Which nursing diagnosis is most relevant for a patient with Hodgkin Disease who has impaired skin integrity?

    <p>Risk of infection</p> Signup and view all the answers

    What is the purpose of administering Allopurinol in the management of Tumor Lysis Syndrome?

    <p>To prevent uric acid formation</p> Signup and view all the answers

    Which assessment finding is unique to Tumor Lysis Syndrome compared to other oncology emergencies?

    <p>Anuria</p> Signup and view all the answers

    Which medical intervention is primarily utilized for patients with Non-Hodgkin Lymphomas showing aggressive progression?

    <p>Monoclonal antibody therapy</p> Signup and view all the answers

    What is a primary complication of Tumor Lysis Syndrome due to the release of intracellular contents into the blood?

    <p>Severe muscle cramps</p> Signup and view all the answers

    Which staging method is commonly used for diagnosing Hodgkin Disease?

    <p>Staging I to IV</p> Signup and view all the answers

    Why is promoting adequate hydration critical in the management of Tumor Lysis Syndrome?

    <p>To prevent renal failure</p> Signup and view all the answers

    Which feature distinguishes localized radiation therapy in Hodgkin Disease management from other treatments like chemotherapy?

    <p>Direct treatment to affected lymph nodes</p> Signup and view all the answers

    In palliative care, what is the primary goal when integrating the psychological and spiritual aspects of care?

    <p>To ensure emotional and spiritual peace</p> Signup and view all the answers

    What is a key diagnostic tool for assessing Non-Hodgkin Lymphomas that involves the study of the lymphoid tissue?

    <p>Lymphoid tissue biopsy</p> Signup and view all the answers

    Which symptom is most indicative of Hodgkin Disease?

    <p>Painless lymph node enlargement</p> Signup and view all the answers

    What is the primary role of administering diuretics in patients with Tumor Lysis Syndrome?

    <p>To promote excretion of phosphates and uric acid</p> Signup and view all the answers

    What is a common diagnostic tool used for both Hodgkin and Non-Hodgkin lymphomas?

    <p>Bone marrow aspiration</p> Signup and view all the answers

    Which symptom is a sign of clinical impending death's effect on the circulatory system?

    <p>HR decreases</p> Signup and view all the answers

    Which classification of Non-Hodgkin Lymphomas is known to progress slowly?

    <p>Indolent</p> Signup and view all the answers

    What is the primary diagnostic tool used to stage lymphoma?

    <p>Lymphangiography</p> Signup and view all the answers

    What is the main nursing intervention to manage respiratory difficulty in Hodgkin Disease?

    <p>Administer oxygen and prepare for intubation</p> Signup and view all the answers

    Which of the following treatments is common in the medical management of both Hodgkin Disease and Non-Hodgkin Lymphomas?

    <p>Chemotherapy with antineoplastic drugs</p> Signup and view all the answers

    Which symptom is specifically associated with Tumor Lysis Syndrome (TLS) rather than general cancer symptoms?

    <p>Cardiac dysrhythmias</p> Signup and view all the answers

    What is the goal when integrating the psychological and spiritual aspects of care in palliative care?

    <p>To support emotional well-being and provide spiritual comfort</p> Signup and view all the answers

    What is the primary goal of Medical Management in Hodgkin Disease?

    <p>To achieve remission</p> Signup and view all the answers

    Which diagnostic test is used to assess the spread of Non-Hodgkin Lymphoma?

    <p>Lymphangiography</p> Signup and view all the answers

    What is the primary complication of Tumor Lysis Syndrome due to the release of intracellular contents into the blood?

    <p>Renal failure</p> Signup and view all the answers

    What is the primary purpose of administering Allopurinol in the management of Tumor Lysis Syndrome?

    <p>To prevent uric acid formation</p> Signup and view all the answers

    What is the primary focus of hospice care for terminal patients?

    <p>To provide pain relief and reduce distressing symptoms</p> Signup and view all the answers

    What is a key diagnostic tool for assessing Non-Hodgkin Lymphomas that involves the study of the lymphoid tissue?

    <p>Biopsy</p> Signup and view all the answers

    What is the primary goal of nursing management for cancer patients undergoing chemotherapy?

    <p>To manage side effects</p> Signup and view all the answers

    What is a common assessment finding in both Hodgkin and non-Hodgkin lymphomas?

    <p>Painless lymph node enlargement</p> Signup and view all the answers

    What is the primary mechanism of action of radiation therapy in cancer treatment?

    <p>To destroy cancer cells</p> Signup and view all the answers

    What is the primary benefit of peripheral stem cell transplant in cancer treatment?

    <p>To restore bone marrow function</p> Signup and view all the answers

    Study Notes

    Blood Disorders

    • Anemia: deficiency of erythrocytes or hemoglobin
      • Causes: blood loss, inadequate erythrocyte production, destruction of formed RBCs
      • Assessment findings: inadequate RBC volume, tachycardia, tachypnea, cool, clammy skin, amenorrhea
      • Compensatory mechanisms: tachycardia, tachypnea, cool, clammy skin, amenorrhea
    • Hypovolemic Anemia
      • Causes: sudden loss of large volume, chronic loss of small amounts of blood
      • Assessment findings: extreme pallor, tachycardia, hypotension, reduced urine output, altered consciousness, fatigue, chills, rapid respiratory rate
      • Medical management: blood transfusions, administration of oral, IV, or IM iron
      • Nursing process: monitor results of CBC, assess vital signs, monitor I&O
    • Iron Deficiency Anemia
      • Causes: insufficient iron to produce hemoglobin
      • Assessment findings: reduced energy, feeling cold, fatigue, and dyspnea with minor physical exertion, rapid heart rate even at rest, decreased hemoglobin, hematocrit, and serum iron levels
      • Medical management: foods high in iron, blood transfusions
      • Nursing management: increase iron intake, collaborate with dietitian, administer iron supplement (IM Z-track)
    • Sickle Cell Anemia
      • Causes: Hemoglobin A replaced by Hemoglobin S; sickle- or crescent-shaped erythrocytes from inadequate oxygen supply to blood
      • Assessment findings: jaundice, tachycardia, dyspnea, cardiomegaly, and dysrhythmias; stroke, acute chest syndrome
      • Medical management: supportive treatment, regular blood transfusions, bone marrow transplantation, prophylactic antibiotic therapy
      • Nursing process: assess health history, vital signs, physical assessment, evident dehydration, and pain; provide analgesics, oxygen, and fluids
    • Hemolytic Anemia
      • Causes: chronic premature erythrocyte destruction
      • Assessment findings: jaundice, enlarged spleen, shock
      • Medical management: removing the cause, corticosteroids, blood transfusions
      • Nursing management: health history, supportive care, medication, teaching measures of self-care, arrange follow-up evaluations
    • Thalassemia
      • Causes: hereditary hemolytic anemia
      • Assessment findings: Cooley's anemia: bronzing of the skin
      • Medical management: symptomatic, frequent transfusions, iron chelation therapy
      • Nursing management: bed rest, protect from infection, closely monitor blood transfusion
    • Pernicious Anemia
      • Causes: lack of intrinsic factor necessary for absorption of vitamin B12
      • Assessment findings: stomatitis, glossitis, digestive disturbances, diarrhea, dyspnea with minimal exertion, jaundice, irritability, confusion, depression, numbness, and tingling in arms and legs, ataxia
      • Medical management: IM vitamin B12, physical therapy for permanent neurologic deficits
      • Nursing management: soft, bland diet, small, frequent meals, oral care, encourage and assist with ambulation, supervision
    • Folic Acid Deficiency Anemia
      • Causes: immature erythrocytes, insufficient dietary intake of foods rich in folic acid
      • Assessment findings: severe fatigue, sore and beefy-red tongue, dyspnea, nausea, anorexia, headaches, weakness, light-headedness
      • Medical management: folic acid supplements, balanced diet
      • Nursing management: teaching, diet, oral hygiene, rest promotion

    Leukocytosis and Leukemia

    • Leukocytosis: proliferation of leukocytes, usually in immature form
      • Causes: genetic correlation, precipitating factors
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis
    • Leukemia
      • Types: acute and chronic forms of lymphocytic and myelogenous leukemia
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis

    Cancer

    • Definition: abnormal, unregulated cell growth; neoplasms
      • Classifications: carcinomas, lymphomas, leukemias, sarcomas
      • TNM classification: tumor, node, metastasis
      • Stages: I to IV
    • Etiology: genetic mutation, environmental factors, chemicals, radiation, viruses
      • Factors: chemical agents, environmental factors, diet, viruses, bacteria, medications, immune system
      • Signs and symptoms: headaches, weight loss, chronic pain, persistent fatigue, low-grade fever, infections
      • Diagnostic tests: client's history, physical examination, laboratory tests, imaging studies, biopsies
    • Cancer treatment
      • Surgery: primary method of diagnosing, staging, and treating
      • Radiation: destroys cell by breaking a strand of DNA molecule, preventing growth
      • Chemotherapy: antineoplastic agents, cell cycle patterns
      • Targeted therapies: biologic response modifiers, monoclonal antibody immunotherapy, cancer vaccines
      • Stem cell transplant: replaces bone marrow destroyed by cancer or cancer treatments
    • Nursing care plan
      • Nursing diagnosis: fatigue, imbalanced nutrition, disturbed body image
      • Interventions: encourage protein and calorie intake, plan care around energy level, administer antiemetics, explore strengths and resources

    Coagulopathies

    • Thrombocytopenia: platelet manufacture by bone marrow is decreased or platelet destruction by the spleen is increased
      • Causes: leukemia, malignant blood diseases, severe infections
      • Assessment findings: purpura, bleeding, internal hemorrhage
      • Medical management: eliminate cause, corticosteroids, transfusions
      • Surgical management: splenectomy
      • Nursing management: manage/minimize bleeding, apply pressure/tourniquet, ADR, taper corticosteroid dosage/frequency
    • Hemophilia: clotting factor, inherited: mother to son
      • Assessment findings: oozing, severe bleeding, bleeding in joints
      • Diagnostic findings: coagulant factor assay
      • Medical management: transfusions, thrombin/fibrin application, fresh frozen plasma, direct pressure
      • Nursing management: health history, physical assessment, VS, prevent trauma, minimize bleeding, reduce pain or discomfort
    • Disseminated Intravascular Coagulation (DIC)
      • Causes: shock, infections, trauma, burns, transfusion reaction, cancer, and obstetric complications
      • Assessment findings: petechiae, purpura, ecchymoses, tachycardia, hypotension, cold/mottled fingers and toes
      • Medical management: correction of the cause, replacement of platelets, coagulation factors, and fibrinogen
      • Nursing management: assess pain, signs of infection, fatigue, bleeding, thrombus formation, urine output, safety, prevent infection

    Palliative Care

    • Definition: neither hastens nor postpones death, provides pain relief and reduces distressing symptoms
      • Integrates the psychological and spiritual aspects of care
      • Provides support system to help clients live as actively as possible until death
      • Referral to support system to help clients' families cope during the client's illness and in their own bereavement
    • Hospice care
      • Initiated for patients as they near the end of life
      • Emphasizes quality of life
      • Patient and family are included in plan of care
      • Provides support for a dignified and peaceful death
      • Palliative rather than curative

    Blood Disorders

    • Anemia: deficiency of erythrocytes or hemoglobin
      • Causes: blood loss, inadequate erythrocyte production, destruction of formed RBCs
      • Assessment findings: inadequate RBC volume, tachycardia, tachypnea, cool, clammy skin, amenorrhea
      • Compensatory mechanisms: tachycardia, tachypnea, cool, clammy skin, amenorrhea
    • Hypovolemic Anemia
      • Causes: sudden loss of large volume, chronic loss of small amounts of blood
      • Assessment findings: extreme pallor, tachycardia, hypotension, reduced urine output, altered consciousness, fatigue, chills, rapid respiratory rate
      • Medical management: blood transfusions, administration of oral, IV, or IM iron
      • Nursing process: monitor results of CBC, assess vital signs, monitor I&O
    • Iron Deficiency Anemia
      • Causes: insufficient iron to produce hemoglobin
      • Assessment findings: reduced energy, feeling cold, fatigue, and dyspnea with minor physical exertion, rapid heart rate even at rest, decreased hemoglobin, hematocrit, and serum iron levels
      • Medical management: foods high in iron, blood transfusions
      • Nursing management: increase iron intake, collaborate with dietitian, administer iron supplement (IM Z-track)
    • Sickle Cell Anemia
      • Causes: Hemoglobin A replaced by Hemoglobin S; sickle- or crescent-shaped erythrocytes from inadequate oxygen supply to blood
      • Assessment findings: jaundice, tachycardia, dyspnea, cardiomegaly, and dysrhythmias; stroke, acute chest syndrome
      • Medical management: supportive treatment, regular blood transfusions, bone marrow transplantation, prophylactic antibiotic therapy
      • Nursing process: assess health history, vital signs, physical assessment, evident dehydration, and pain; provide analgesics, oxygen, and fluids
    • Hemolytic Anemia
      • Causes: chronic premature erythrocyte destruction
      • Assessment findings: jaundice, enlarged spleen, shock
      • Medical management: removing the cause, corticosteroids, blood transfusions
      • Nursing management: health history, supportive care, medication, teaching measures of self-care, arrange follow-up evaluations
    • Thalassemia
      • Causes: hereditary hemolytic anemia
      • Assessment findings: Cooley's anemia: bronzing of the skin
      • Medical management: symptomatic, frequent transfusions, iron chelation therapy
      • Nursing management: bed rest, protect from infection, closely monitor blood transfusion
    • Pernicious Anemia
      • Causes: lack of intrinsic factor necessary for absorption of vitamin B12
      • Assessment findings: stomatitis, glossitis, digestive disturbances, diarrhea, dyspnea with minimal exertion, jaundice, irritability, confusion, depression, numbness, and tingling in arms and legs, ataxia
      • Medical management: IM vitamin B12, physical therapy for permanent neurologic deficits
      • Nursing management: soft, bland diet, small, frequent meals, oral care, encourage and assist with ambulation, supervision
    • Folic Acid Deficiency Anemia
      • Causes: immature erythrocytes, insufficient dietary intake of foods rich in folic acid
      • Assessment findings: severe fatigue, sore and beefy-red tongue, dyspnea, nausea, anorexia, headaches, weakness, light-headedness
      • Medical management: folic acid supplements, balanced diet
      • Nursing management: teaching, diet, oral hygiene, rest promotion

    Leukocytosis and Leukemia

    • Leukocytosis: proliferation of leukocytes, usually in immature form
      • Causes: genetic correlation, precipitating factors
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis
    • Leukemia
      • Types: acute and chronic forms of lymphocytic and myelogenous leukemia
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis

    Cancer

    • Definition: abnormal, unregulated cell growth; neoplasms
      • Classifications: carcinomas, lymphomas, leukemias, sarcomas
      • TNM classification: tumor, node, metastasis
      • Stages: I to IV
    • Etiology: genetic mutation, environmental factors, chemicals, radiation, viruses
      • Factors: chemical agents, environmental factors, diet, viruses, bacteria, medications, immune system
      • Signs and symptoms: headaches, weight loss, chronic pain, persistent fatigue, low-grade fever, infections
      • Diagnostic tests: client's history, physical examination, laboratory tests, imaging studies, biopsies
    • Cancer treatment
      • Surgery: primary method of diagnosing, staging, and treating
      • Radiation: destroys cell by breaking a strand of DNA molecule, preventing growth
      • Chemotherapy: antineoplastic agents, cell cycle patterns
      • Targeted therapies: biologic response modifiers, monoclonal antibody immunotherapy, cancer vaccines
      • Stem cell transplant: replaces bone marrow destroyed by cancer or cancer treatments
    • Nursing care plan
      • Nursing diagnosis: fatigue, imbalanced nutrition, disturbed body image
      • Interventions: encourage protein and calorie intake, plan care around energy level, administer antiemetics, explore strengths and resources

    Coagulopathies

    • Thrombocytopenia: platelet manufacture by bone marrow is decreased or platelet destruction by the spleen is increased
      • Causes: leukemia, malignant blood diseases, severe infections
      • Assessment findings: purpura, bleeding, internal hemorrhage
      • Medical management: eliminate cause, corticosteroids, transfusions
      • Surgical management: splenectomy
      • Nursing management: manage/minimize bleeding, apply pressure/tourniquet, ADR, taper corticosteroid dosage/frequency
    • Hemophilia: clotting factor, inherited: mother to son
      • Assessment findings: oozing, severe bleeding, bleeding in joints
      • Diagnostic findings: coagulant factor assay
      • Medical management: transfusions, thrombin/fibrin application, fresh frozen plasma, direct pressure
      • Nursing management: health history, physical assessment, VS, prevent trauma, minimize bleeding, reduce pain or discomfort
    • Disseminated Intravascular Coagulation (DIC)
      • Causes: shock, infections, trauma, burns, transfusion reaction, cancer, and obstetric complications
      • Assessment findings: petechiae, purpura, ecchymoses, tachycardia, hypotension, cold/mottled fingers and toes
      • Medical management: correction of the cause, replacement of platelets, coagulation factors, and fibrinogen
      • Nursing management: assess pain, signs of infection, fatigue, bleeding, thrombus formation, urine output, safety, prevent infection

    Palliative Care

    • Definition: neither hastens nor postpones death, provides pain relief and reduces distressing symptoms
      • Integrates the psychological and spiritual aspects of care
      • Provides support system to help clients live as actively as possible until death
      • Referral to support system to help clients' families cope during the client's illness and in their own bereavement
    • Hospice care
      • Initiated for patients as they near the end of life
      • Emphasizes quality of life
      • Patient and family are included in plan of care
      • Provides support for a dignified and peaceful death
      • Palliative rather than curative

    Blood Disorders

    • Anemia: deficiency of erythrocytes or hemoglobin
      • Causes: blood loss, inadequate erythrocyte production, destruction of formed RBCs
      • Assessment findings: inadequate RBC volume, tachycardia, tachypnea, cool, clammy skin, amenorrhea
      • Compensatory mechanisms: tachycardia, tachypnea, cool, clammy skin, amenorrhea
    • Hypovolemic Anemia
      • Causes: sudden loss of large volume, chronic loss of small amounts of blood
      • Assessment findings: extreme pallor, tachycardia, hypotension, reduced urine output, altered consciousness, fatigue, chills, rapid respiratory rate
      • Medical management: blood transfusions, administration of oral, IV, or IM iron
      • Nursing process: monitor results of CBC, assess vital signs, monitor I&O
    • Iron Deficiency Anemia
      • Causes: insufficient iron to produce hemoglobin
      • Assessment findings: reduced energy, feeling cold, fatigue, and dyspnea with minor physical exertion, rapid heart rate even at rest, decreased hemoglobin, hematocrit, and serum iron levels
      • Medical management: foods high in iron, blood transfusions
      • Nursing management: increase iron intake, collaborate with dietitian, administer iron supplement (IM Z-track)
    • Sickle Cell Anemia
      • Causes: Hemoglobin A replaced by Hemoglobin S; sickle- or crescent-shaped erythrocytes from inadequate oxygen supply to blood
      • Assessment findings: jaundice, tachycardia, dyspnea, cardiomegaly, and dysrhythmias; stroke, acute chest syndrome
      • Medical management: supportive treatment, regular blood transfusions, bone marrow transplantation, prophylactic antibiotic therapy
      • Nursing process: assess health history, vital signs, physical assessment, evident dehydration, and pain; provide analgesics, oxygen, and fluids
    • Hemolytic Anemia
      • Causes: chronic premature erythrocyte destruction
      • Assessment findings: jaundice, enlarged spleen, shock
      • Medical management: removing the cause, corticosteroids, blood transfusions
      • Nursing management: health history, supportive care, medication, teaching measures of self-care, arrange follow-up evaluations
    • Thalassemia
      • Causes: hereditary hemolytic anemia
      • Assessment findings: Cooley's anemia: bronzing of the skin
      • Medical management: symptomatic, frequent transfusions, iron chelation therapy
      • Nursing management: bed rest, protect from infection, closely monitor blood transfusion
    • Pernicious Anemia
      • Causes: lack of intrinsic factor necessary for absorption of vitamin B12
      • Assessment findings: stomatitis, glossitis, digestive disturbances, diarrhea, dyspnea with minimal exertion, jaundice, irritability, confusion, depression, numbness, and tingling in arms and legs, ataxia
      • Medical management: IM vitamin B12, physical therapy for permanent neurologic deficits
      • Nursing management: soft, bland diet, small, frequent meals, oral care, encourage and assist with ambulation, supervision
    • Folic Acid Deficiency Anemia
      • Causes: immature erythrocytes, insufficient dietary intake of foods rich in folic acid
      • Assessment findings: severe fatigue, sore and beefy-red tongue, dyspnea, nausea, anorexia, headaches, weakness, light-headedness
      • Medical management: folic acid supplements, balanced diet
      • Nursing management: teaching, diet, oral hygiene, rest promotion

    Leukocytosis and Leukemia

    • Leukocytosis: proliferation of leukocytes, usually in immature form
      • Causes: genetic correlation, precipitating factors
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis
    • Leukemia
      • Types: acute and chronic forms of lymphocytic and myelogenous leukemia
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis

    Cancer

    • Definition: abnormal, unregulated cell growth; neoplasms
      • Classifications: carcinomas, lymphomas, leukemias, sarcomas
      • TNM classification: tumor, node, metastasis
      • Stages: I to IV
    • Etiology: genetic mutation, environmental factors, chemicals, radiation, viruses
      • Factors: chemical agents, environmental factors, diet, viruses, bacteria, medications, immune system
      • Signs and symptoms: headaches, weight loss, chronic pain, persistent fatigue, low-grade fever, infections
      • Diagnostic tests: client's history, physical examination, laboratory tests, imaging studies, biopsies
    • Cancer treatment
      • Surgery: primary method of diagnosing, staging, and treating
      • Radiation: destroys cell by breaking a strand of DNA molecule, preventing growth
      • Chemotherapy: antineoplastic agents, cell cycle patterns
      • Targeted therapies: biologic response modifiers, monoclonal antibody immunotherapy, cancer vaccines
      • Stem cell transplant: replaces bone marrow destroyed by cancer or cancer treatments
    • Nursing care plan
      • Nursing diagnosis: fatigue, imbalanced nutrition, disturbed body image
      • Interventions: encourage protein and calorie intake, plan care around energy level, administer antiemetics, explore strengths and resources

    Coagulopathies

    • Thrombocytopenia: platelet manufacture by bone marrow is decreased or platelet destruction by the spleen is increased
      • Causes: leukemia, malignant blood diseases, severe infections
      • Assessment findings: purpura, bleeding, internal hemorrhage
      • Medical management: eliminate cause, corticosteroids, transfusions
      • Surgical management: splenectomy
      • Nursing management: manage/minimize bleeding, apply pressure/tourniquet, ADR, taper corticosteroid dosage/frequency
    • Hemophilia: clotting factor, inherited: mother to son
      • Assessment findings: oozing, severe bleeding, bleeding in joints
      • Diagnostic findings: coagulant factor assay
      • Medical management: transfusions, thrombin/fibrin application, fresh frozen plasma, direct pressure
      • Nursing management: health history, physical assessment, VS, prevent trauma, minimize bleeding, reduce pain or discomfort
    • Disseminated Intravascular Coagulation (DIC)
      • Causes: shock, infections, trauma, burns, transfusion reaction, cancer, and obstetric complications
      • Assessment findings: petechiae, purpura, ecchymoses, tachycardia, hypotension, cold/mottled fingers and toes
      • Medical management: correction of the cause, replacement of platelets, coagulation factors, and fibrinogen
      • Nursing management: assess pain, signs of infection, fatigue, bleeding, thrombus formation, urine output, safety, prevent infection

    Palliative Care

    • Definition: neither hastens nor postpones death, provides pain relief and reduces distressing symptoms
      • Integrates the psychological and spiritual aspects of care
      • Provides support system to help clients live as actively as possible until death
      • Referral to support system to help clients' families cope during the client's illness and in their own bereavement
    • Hospice care
      • Initiated for patients as they near the end of life
      • Emphasizes quality of life
      • Patient and family are included in plan of care
      • Provides support for a dignified and peaceful death
      • Palliative rather than curative

    Blood Disorders

    • Anemia: deficiency of erythrocytes or hemoglobin
      • Causes: blood loss, inadequate erythrocyte production, destruction of formed RBCs
      • Assessment findings: inadequate RBC volume, tachycardia, tachypnea, cool, clammy skin, amenorrhea
      • Compensatory mechanisms: tachycardia, tachypnea, cool, clammy skin, amenorrhea
    • Hypovolemic Anemia
      • Causes: sudden loss of large volume, chronic loss of small amounts of blood
      • Assessment findings: extreme pallor, tachycardia, hypotension, reduced urine output, altered consciousness, fatigue, chills, rapid respiratory rate
      • Medical management: blood transfusions, administration of oral, IV, or IM iron
      • Nursing process: monitor results of CBC, assess vital signs, monitor I&O
    • Iron Deficiency Anemia
      • Causes: insufficient iron to produce hemoglobin
      • Assessment findings: reduced energy, feeling cold, fatigue, and dyspnea with minor physical exertion, rapid heart rate even at rest, decreased hemoglobin, hematocrit, and serum iron levels
      • Medical management: foods high in iron, blood transfusions
      • Nursing management: increase iron intake, collaborate with dietitian, administer iron supplement (IM Z-track)
    • Sickle Cell Anemia
      • Causes: Hemoglobin A replaced by Hemoglobin S; sickle- or crescent-shaped erythrocytes from inadequate oxygen supply to blood
      • Assessment findings: jaundice, tachycardia, dyspnea, cardiomegaly, and dysrhythmias; stroke, acute chest syndrome
      • Medical management: supportive treatment, regular blood transfusions, bone marrow transplantation, prophylactic antibiotic therapy
      • Nursing process: assess health history, vital signs, physical assessment, evident dehydration, and pain; provide analgesics, oxygen, and fluids
    • Hemolytic Anemia
      • Causes: chronic premature erythrocyte destruction
      • Assessment findings: jaundice, enlarged spleen, shock
      • Medical management: removing the cause, corticosteroids, blood transfusions
      • Nursing management: health history, supportive care, medication, teaching measures of self-care, arrange follow-up evaluations
    • Thalassemia
      • Causes: hereditary hemolytic anemia
      • Assessment findings: Cooley's anemia: bronzing of the skin
      • Medical management: symptomatic, frequent transfusions, iron chelation therapy
      • Nursing management: bed rest, protect from infection, closely monitor blood transfusion
    • Pernicious Anemia
      • Causes: lack of intrinsic factor necessary for absorption of vitamin B12
      • Assessment findings: stomatitis, glossitis, digestive disturbances, diarrhea, dyspnea with minimal exertion, jaundice, irritability, confusion, depression, numbness, and tingling in arms and legs, ataxia
      • Medical management: IM vitamin B12, physical therapy for permanent neurologic deficits
      • Nursing management: soft, bland diet, small, frequent meals, oral care, encourage and assist with ambulation, supervision
    • Folic Acid Deficiency Anemia
      • Causes: immature erythrocytes, insufficient dietary intake of foods rich in folic acid
      • Assessment findings: severe fatigue, sore and beefy-red tongue, dyspnea, nausea, anorexia, headaches, weakness, light-headedness
      • Medical management: folic acid supplements, balanced diet
      • Nursing management: teaching, diet, oral hygiene, rest promotion

    Leukocytosis and Leukemia

    • Leukocytosis: proliferation of leukocytes, usually in immature form
      • Causes: genetic correlation, precipitating factors
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis
    • Leukemia
      • Types: acute and chronic forms of lymphocytic and myelogenous leukemia
      • Assessment findings: severe anemia, infections, fatigue, easy bruising, fever, enlarged spleen and lymph nodes, internal or external bleeding
      • Medical management: antineoplastic drugs, transfusions, transplantation: bone marrow, stem cell
      • Nursing process: assess history of symptoms, physical assessment, laboratory results, assess neutrophil, monitor platelet counts, assess for signs of bruising and petechiae, report hematuria or epistaxis

    Cancer

    • Definition: abnormal, unregulated cell growth; neoplasms
      • Classifications: carcinomas, lymphomas, leukemias, sarcomas
      • TNM classification: tumor, node, metastasis
      • Stages: I to IV
    • Etiology: genetic mutation, environmental factors, chemicals, radiation, viruses
      • Factors: chemical agents, environmental factors, diet, viruses, bacteria, medications, immune system
      • Signs and symptoms: headaches, weight loss, chronic pain, persistent fatigue, low-grade fever, infections
      • Diagnostic tests: client's history, physical examination, laboratory tests, imaging studies, biopsies
    • Cancer treatment
      • Surgery: primary method of diagnosing, staging, and treating
      • Radiation: destroys cell by breaking a strand of DNA molecule, preventing growth
      • Chemotherapy: antineoplastic agents, cell cycle patterns
      • Targeted therapies: biologic response modifiers, monoclonal antibody immunotherapy, cancer vaccines
      • Stem cell transplant: replaces bone marrow destroyed by cancer or cancer treatments
    • Nursing care plan
      • Nursing diagnosis: fatigue, imbalanced nutrition, disturbed body image
      • Interventions: encourage protein and calorie intake, plan care around energy level, administer antiemetics, explore strengths and resources

    Coagulopathies

    • Thrombocytopenia: platelet manufacture by bone marrow is decreased or platelet destruction by the spleen is increased
      • Causes: leukemia, malignant blood diseases, severe infections
      • Assessment findings: purpura, bleeding, internal hemorrhage
      • Medical management: eliminate cause, corticosteroids, transfusions
      • Surgical management: splenectomy
      • Nursing management: manage/minimize bleeding, apply pressure/tourniquet, ADR, taper corticosteroid dosage/frequency
    • Hemophilia: clotting factor, inherited: mother to son
      • Assessment findings: oozing, severe bleeding, bleeding in joints
      • Diagnostic findings: coagulant factor assay
      • Medical management: transfusions, thrombin/fibrin application, fresh frozen plasma, direct pressure
      • Nursing management: health history, physical assessment, VS, prevent trauma, minimize bleeding, reduce pain or discomfort
    • Disseminated Intravascular Coagulation (DIC)
      • Causes: shock, infections, trauma, burns, transfusion reaction, cancer, and obstetric complications
      • Assessment findings: petechiae, purpura, ecchymoses, tachycardia, hypotension, cold/mottled fingers and toes
      • Medical management: correction of the cause, replacement of platelets, coagulation factors, and fibrinogen
      • Nursing management: assess pain, signs of infection, fatigue, bleeding, thrombus formation, urine output, safety, prevent infection

    Palliative Care

    • Definition: neither hastens nor postpones death, provides pain relief and reduces distressing symptoms
      • Integrates the psychological and spiritual aspects of care
      • Provides support system to help clients live as actively as possible until death
      • Referral to support system to help clients' families cope during the client's illness and in their own bereavement
    • Hospice care
      • Initiated for patients as they near the end of life
      • Emphasizes quality of life
      • Patient and family are included in plan of care
      • Provides support for a dignified and peaceful death
      • Palliative rather than curative

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    Learn about Anemia and Sickle Cell Anemia, including causes, assessment findings, and compensatory mechanisms. Prepare for your Medical-Surgical exam with Cardiovascular System topics.

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